Wednesday, November 19, 2014

Affordable Care Act / Obamacare and Health Insurance enrollment. - What Mpowerment Projects can do.

Everyone needs access to affordable health care, especially young adult bisexual and gay men. 

Millennial young bisexual and gay men's lives are in transition. There is a lot going on. Moving out, being independent, finding a job and/or going to a University or Community College.  Why is it important to think about preventative health care?  Yes, well gay men are at increased risk for certain chronic diseases and mental health problems. HIV infections are also increasing among young adult gay and bisexual men.  Think about it, nobody should go broke because they become ill, need medications or break an arm. Let's make it a goal to get more young men enrolled in health insurance. 


The DENIM Collection | Mpowerment Washington DC

This year open enrollment for the Affordable Care Act (ACA) / Obamacare begins November 1, 2015. 

The deadline to sign up for coverage for January 1, 2016. 

Open enrollment ends January 31, 2016.

If you want a new plan to start January 1, 2015, you must renew or change your plan by December 15, 2014.

We need your help to keep things moving in the right direction for young adults. What can your Mpowerment Project do to encourage discussion about the ACA/Obamacare?  Mpowerment Projects (MP) can bring awareness and information about enrolling in health insurance coverage to their participants. Let these helpful sites guide you.

The Affordable Care Act helps young adult Gay and Bi men living with HIV. Here are some of the many ways that Obamacare helps everyone living with HIV. 




The Affordable Care Act and PrEP (see below).


What are your reasons to #GetCovered?

"Everything you need to bring the Affordable Care Act to your community."

The Healthy Young America Playbook

via Young Invincibles 






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"How to make the ACA T'werk for you" via Young Black Gay Mens Leadership Initiative


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Got Covered with Haven Mpowerment Project | Springfield MO

Mpowerment Projects can host discussion events on the importance of health insurance coverage and why young Gay/Bi men can benefit from having insurance. Have your Core Group members discuss ideas on how to get more young men enrolled in health care. Download the Out2Enroll social media toolkit for more ideas (see below).

"Maybe you’re celebrating pride or participating in a community health fair? We have some materials that may be able to help you communicate the importance of being Out2Enroll."

Check out the Out2Enroll resources. 
Borrow from the Out2Enroll Campaigns.



Get Enrolled Holiday 2013 video 

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"Affordable health insurance is here. You might be able to get covered now." Get Covered America.


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Get Covered. Health Care dot Gov.

The men of Latinos D | Mpowerment New York City NY

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New Data: Millennials Are Better Off with Obamacare

"We've known for a long time that if you give Millennials options for quality, affordable health insurance, they're going to enroll. Uninsured young adults know that they're just one accident or illness away from a medical and economic catastrophe.
In our outreach efforts across the country, many young adults say they were locked into jobs before the ACA became law -- just to have health insurance. Now that there are many affordable health plan options through the marketplace, it's no surprise that so many young people are signing up." 
Out2Enroll.org


I want to go on PrEP but I don’t have health insurance or a doctor. What’s the first step I should take? via betablog.org 


"To get Truvada for PrEP, you will need a prescription from a medical provider, so your first step is to make an appointment at a health center or clinic that has primary care and/or sexual health services and accepts patients without insurance. In selecting a clinic, you may want to ask whether they have providers who are able to prescribe PrEP and are open to discussing PrEP with their patients. Doctors, nurse practitioners, and physician assistants are all qualified to write PrEP prescriptions.
If you are uninsured, now is a great time to get coverage. The Affordable Care Act (AKA “Obamacare”) requires that all US citizens have insurance. Depending on your income, you may be eligible for Medicaid, or you may be able to purchase insurance through an online marketplace. (In California, this marketplace is called Covered California; if you live outside of California, visit Healthcare.gov) Depending on your individual circumstances, you may be able to get insurance now, or may need to wait for the next enrollment period to open. When choosing a plan, you’ll want to consider whether Truvada for PrEP is covered by the plan and at what cost (i.e., what the co-pay is for Truvada).
Here is a step-by-step checklist of what you need to make your appointment.
  1. If you are uninsured, visit CoveredCA.com (if you live in California) or Healthcare.gov (if you live outside of California) to learn more about getting coverage.
  2. Make an appointment to get PrEP at a health center that has primary care/sexual health services and accepts patients without insurance (or accepts your insurance if you are insured).
  3. Ask for a sexual health check-up and an evaluation for PrEP. Set up a reminder so you don’t miss the appointment.
  4. Do your homework: Check out the CDC’s brochure “How to talk to your doctor about PrEP", PrEPfacts.org, My PrEP Experience blog and Project Inform for information and support. 


Accessing PrEP is a process. It may take a few weeks to months to process any required paperwork and have baseline lab tests performed prior to getting a prescription for PrEP."
Pedro and Gustavo | Generation L Mpowerment Chicago IL -  USCA 2014








Friday, November 14, 2014

16 Steps. Starting the Mpowerment Project in your community

via the Mpowerment Manual - Module 1 Overview.


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Admit you have a problem - you need to implement your Mpowerment Project (MP) and you haven't a clue where to begin. That's the goal of this blog post, to guide you through the general steps of starting an Mpowerment Project in your community. Developing a time frame to start a Project differs from community to community and from budget to budget. Each community must adapt these steps to it's Project's goals, funding for the program, and level of interest they are able to generate within the community. 

Keep in mind that many of these steps overlap. You can work on more than one simultaneously. You do not necessarily complete one step before beginning another. For example, you will be meeting with leaders in your community to promote awareness of your MP during the same time that you will have your coordinators conducting a community assessment and establishing a Core Group.

RELATED:  What is the Mpowerment Project? Download Module 1: Mpowerment Overview.

The Evolution Project | Mpowerment Atlanta GA
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Step 1 The Executive Director and HIV Prevention/Education Supervisor become familiar with the basic ideas of the Mpowerment Project. Review materials on mpowerment.org, including the Executive Director audio- slideshow (an online presentation that summarizes information critical for Executive Directors). Consult with Technical Assistance providers at the UCSF Capacity Building Assistance Partnership.

FUSE | Mpowerment Dallas Texas
Step 2 Assess whether the agency is ready to implement the Mpowerment Project’s Core Elements, following the Guiding Principles. The Guiding Principles are explained the Overview Module. Determine if the Mpowerment Project is a good fit for the agency and community.

Step 3 Secure adequate funding for the Project. (Download Module 3:Implementing Agency for more information about funding issues.) Starting the Project with only a half-time staff person is unlikely to result in a well- functioning program. Technical Assistance providers from the UCSF Capacity Building Assistance Partnership can also help by providing sample proposals and budget information, and by reviewing draft proposals.

RELATEDFunding best practices, interview with a funder.  


Step 4 Identify appropriate staff to serve as Coordinators for the Project by sending job announcements to agencies, by placing ads on appropriate Internet sites (e.g., craigslist), and by placing ads in local gay/bisexual, alternative, and university newspapers (See Module 4: Coordinators). Hiring staff that are appropriate for the intervention is one of the most important issues with respect to being able to implement the Project successfully.
 

Step 5 Hire and train Project Coordinator or Coordinators (Download Module3: Implementing Agency, and Module 4: Coordinators), review materials on the Mpowerment website, and attend the Mpowerment training. Let us know how we can assist your organization.

RELATED:  Join us. Attend the Mpowerment Project training


Step 6 Perform baseline evaluations of sexual risk behavior among young gay/bisexual men in the community before starting to implement the Project  Download Module 12: Evaluation.

Step 7 Coordinators conduct the community assessment (Download and read Module
SOMOS OC | Mpowerment Orange County CA
2: Community Assessment). This will help you to identify the different groups of young adult bisexual and gay men in the community, community resources, and people in the community who are relevant to the Project. It is important to note that this is not a “Needs Assessment,” which is generally a much larger, more complicated, and more expensive task.

Step 8 Meet with community leaders and relevant agencies to inform them of the Project.  Download Module 2: Community Assessment, Module 4:Coordinators, and Module 11: Community Advisory Board.

Step 9 Assemble a Core Group (Download Module 5: Core Group). This involves: 

  1. identifying potential Core Group members from the different segments of the young gay/bisexual men’s community, and 
  2. convening a meeting with them in which the Project is described to them and they are invited to join the Core Group.

Step 10 Coordinators and the Core Group (with approval from implementing agency) locate a Project space and furnish it (Download Module 6:Project Space).

Step 11 Identify and train additional M-group facilitators if you only have one Coordinator. Be sure to download our latest M-Group facilitators guide for free at www.mpowerment.org.

Step 12 Initiate Social Outreach Events to attract men to the Project and to begin community-building. Download Module 7: Formal Outreach—SocialOutreach Events and Outreach Team.


Mpowerment YVR | Vancouver BC
Step 13 Begin the process of the Core Group selecting a Project name, logo, and tagline (See Module 5: Core Group and Module 10: Publicity), and identifying initial Social Outreach Events that the Core Group wants to conduct and attend (See Module 7: Formal Outreach—Social Outreach Events andOutreach Team).

Step 14 Begin conducting Social Outreach Events. Projects often start off with a medium to large Social Outreach Event as a way of announcing the Project to the community. Other smaller Social Outreach Events are also started (Download Module 7: Formal Outreach—Social Outreach Events andOutreach Team).

Step 15 Develop Project promotional materials, develop a publicity and social media plan, and conduct publicity for Project and Social Outreach Events (Download Module 10:Publicity).


Step 16 Meet with potential Community Advisory Board members, and invite them to join the Community Advisory Board (Download Module 11:Community Advisory Board). 


Grand Opening The Q Austin with a Proclamation by the Mayor in 2014 | Mpowerment Austin Texas 

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The Mpowerment Manual Module 1 Overview and the additional Mpowerment Modules are free downloads when you register at www.mpowerment.org

Be sure to connect with the Mpowerment Project on Facebook and Twitter.




Wednesday, October 15, 2014

Mpowerment and CDC's new funding opportunity | PS15-1502

Hi Folks,
We are writing to everyone who has expressed an interest in or has implemented the Mpowerment Project (MP) over the past few years. We want to alert you to interesting possibilities for funding MP if you or your agency plan to apply for funding under CDC’s FOA PS15-1502.

MP was identified in the FOA as being a “HIP Intervention” suitable both for High Risk HIV Negative (HRN) and HIV Positive Men Who Have Sex With Men (MSM).

Mpowerment Training San Diego 2014 

A.  For High Risk Negative (HRN) Young (MSM). The MP retains its 8 core elements: Coordinators (staff), Core Group, Volunteers, M-groups, Formal Outreach, Informal Outreach, Publicity and Space. It reaches men regardless of HIV status. It focuses on both increasing HIV testing and on reducing sexual risk behavior. We think it is important that HIV testing be addressed in MP, but not only by providing HIV testing itself. Instead, MP methods can also be used to promote regular and frequent HIV testing (every 3 – 6 months) by using formal and informal outreach. You can develop HIV testing promotional materials and distribute them through social media, at project-sponsored events and at venues where young MSM congregate. You can discuss the importance of frequent testing at small, medium and large events. At M-groups, you can discuss the importance of regular and frequent HIV testing. Informal Outreach should focus both on encouraging friends to reduce their risks for acquiring and transmitting HIV, and on increasing HIV testing (e.g., by going with friends to get tested).

A.1.  New Issues to Focus on for HRN MSM. There are 3 major changes that we suggest for HRN MSM. Click here for 10 steps that can be followed for MP to address the HIVCare Continuum.

(a)   PrEP. The MP can be used to educate and inform young gay/bisexual men about PrEP (Pre-exposure Prophylaxis). Information about PrEP can be disseminated in the same ways that safer sex and HIV testing are promoted, i.e., through the use of the core elements, including creating materials on PrEP that are distributed in various ways, increasing formal and informal outreach focused on PrEP, and having materials about PrEP at the space, including where and how to obtain it.

(b)  Condom Distribution. The MP can be used as a way to conduct condom distribution to young gay/bisexual men. The MP has always done this, but it can be formalized by following the guidelines for Condom Distribution provided by CDC. Condoms should be widely distributed via Formal Outreach, at all project-sponsored events and at venues where young MSM congregate. They should be freely available at the project space and given to young men to give to their friends.

(c)   Collaboration with Health Care Organizations (HCOs). It is important for community-based organizations hosting MPs to have a strong collaboration with an HCO so that when a young man reveals to Coordinators that they have tested HIV-positive, he can be navigated into care at an HCO. Hence a strong partnership between the MP and an HCO is extremely important to ensure that all young men identified as HIV-positive are assisted to link to care, or if they have left care or are having challenges in taking medications, they can be referred to the HCO. In addition, the collaboration with the HCO is helpful in referring men to obtain PrEP, or if they need to be tested for STIs.

A.2.  Staffing for HRN MP. As you know, it is difficult to make recommendations about staffing plans, because the staffing needs vary from organization to organization depending on factors such as community size, staff capacity, and other resources available to support MP programming.  The recommendations below are just rough guidelines to keep in mind as you plan your specific work and staffing plans.  Feel free to contact us for assistance in planning your specific proposals.  It is vital to ensure that you have sufficient staffing to meet your program’s goals and objectives, and these will vary by each applicant. We state here the minimum that we suggest requesting in order to run the MP. The FOA states that after considering the amount of HIV testing the agency will do, 25% of the funding can be focused on HRN MSM. We would suggest that at least:


  •       1.5 FTE (full-time equivalent) should be sought for MP
  •        .5 person who is funded through HIV Testing funding (who will both conduct testing and also promote it through MP methods).

Mpowerment Reunion at United States Conference on AIDS | San Diego 2014

B.  For HIV-Positive Young MSM. The MP team has been determining how to use MP methods to address the needs of HIV-positive young MSM – that is, to help them link into care once they have tested HIV-positive, to maintain or re-engage in care if they have left care, and to take their medications regularly. There are additional core elements to focus on HIV-positives that will be fully developed and ready for use by July 2015 that the CDC has accepted as evidence-based since they follow the logic and methods of MP. These additions are listed below. These are to be added to an MP for High Risk Negative MSM.

We do not recommend an MP solely for HIV-positive MSM because many men will feel wary about showing up for something that is only for positives out of concern about HIV stigma. HIV-positive men also do not just spend time with other HIV-positive friends. Therefore, in addition to the goal of reducing risk among HRNs, another MP goal is to mobilize the entire young MSM community to support positives about engaging in the continuum of care. Therefore, it is important to ask for funding for MP, as well as funding for what we are now calling “MP+” (see below). It is important to run an MP, and then add or adapt it to address HIV-positive men and their issues.

B.1.  New Issues to Focus on and New Core Elements for HIV-positive Young MSM.

(a)   Formal Outreach Events for HIV-Positive Men.  It is key for HIV-positive men to get support from friends for linking into care, engaging in care or re-engaging, and taking medications as prescribed. There should be some project-sponsored formal outreach events specifically for HIV+ men in order to help build this support. Not all HIV-positive men will want to attend these, but many will and it may be that as these are held, more and more HIV-positive men will attend. These can be small or medium-sized events. Some can focus on issues about being HIV-positive, but also many HIV-positive men would like an opportunity to be with other guys like themselves (in other words, have a social focus to the events). Various issues of importance to HIV-positive men can be promoted at such events, such as sexual risk reduction, the need to stay in or re-engage in care, remembering to take medications as prescribed, how to work with one’s healthcare provider, how to advocate for yourself, and how to deal with structural issues (e.g., transportation). At formal outreach events that target both HIV-negative and HIV-positive men, activities can be included that give HIV-negative men ideas about and encouragement for supporting their HIV-positive friends to engage in care and take their medications as prescribed.

(b)  HIV Stigma Reduction. Again, all of the MP core elements can be harnessed to address stigma reduction. Messages aimed at reducing HIV stigma can be created for use in the project space and can serve as a theme for materials disseminated throughout the community.  . Themes can include HIV stigma-related gossip and not making assumptions about others’ HIV status. HIV stigma can also be discussed in project-sponsored formal outreach events and at Core Group meetings.

(c)   Adapted M-group. By January 2015, we will be distributing a revised M-group curriculum that will address HIV-positive issues. It aims to increase literacy about treatments, build support for HIV-positives to engage in care and take medications as prescribed, reduce HIV stigma, and other related issues. The M-groups remain the first group than individuals participate in when coming into the project.

(d)  Navigation into Care. Someone connected with the MP will need to help navigate HIV-positive men into care or help them re-engage in care and take medications as prescribed. The navigator can be employed by an HCO to work with the MP, or a staff person who works with MP can be employed to navigate individuals into care. This person should be especially savvy about issues facing young MSM.

(e)   Positives Group. This is a group that totally focuses on the needs of HIV-positive MSM. It is delivered less often than M-groups. The Positives Groups focus on a myriad of issues, including dating and sex; disclosure to partners, friends and family; HIV and medication literacy; health promotion for positives. Individuals will participate in these groups once or twice. These are 2.5 hour-long groups.  Guidance on these groups will be available by July 2015.

(f)   Network Group. HIV-positive young men will identify 1-3 friends from their social networks who they want to bring to a Network group.  They will discuss together how these “buddies” can support the young man regarding being HIV-positive and obtaining the best medical care. The HIV-positive individual identifies areas in which he could use support, how he wants support provided him by his friends, and how often he wants such support.  Again, guidance on these Network Groups will be available by July 2015.


#StigmaSideEye via The Q Austin | Mpowerment Texas

B.2.  Staffing for MP+. We state here the minimum that we suggest requesting in order to run MP+ (along with finding other sources of funding). These recommendations are for organizations doing both MP and MP+ (i.e., reaching both HIV positive and negative men). This is just a suggestion for one way to staff the entire program for positive and negative men.. Certainly there are many other possibilities. We suggest requesting:

-       1 FTE for HIV testing, and this position not only conducts testing, but also uses MP core elements to promote HIV testing, recruit men for testing and so forth (as was described earlier). This could come from HIV testing funding.

-       1 FTE for MP implementation, of which 75% will be for MP and 25% will be for conducting HIV testing. This could come from HRN funding.

-       1 FTE for MP+ implementation, of which 75% will be for the Positives Group, Triads, and MP core elements that are adapted to focus on HIV-positive men (e.g., events for HIV-positives), and 25% will be for Navigation.

In summary, we believe that it would take at least 3 total FTE to implement both MP and MP+ to reach HIV-positive and HIV-negative men together.

Please contact us if you have any questions about this.  We can be contacted at:

Robert Williams                   Robert.Williams@ucsf.edu
John Hamiga                         John.Hamiga@ucsf.edu
Scott Tebbetts                     Scott.Tebbetts@ucsf.edu


Follow these amazing MPs.  @mpcaps